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Dr. Frascino - Please Reply Back

May 1, 2003

Hello Dr. Frascino:

I honestly believe that you deserve a Noble Prize for your courage, compassion and the service you are providing to anxiety afflicted people all over the world. Your forum on Internet is definitely unique.

I am extremely stressed. I wrote to you once before and you responded back on April 29, 2003 (Worried, Stressed, Distressed) and said that you had thousands of messages in your inbox and as a result didnt know which question I had asked you. I am resubmitting my question with your name in the title as you had requested in your response. I apologize for this long message but I wanted to give you all the information to get a conclusive answer. I would highly appreciate if you would be prompt in replying back. Thanks.

Let me begin the story. I am 25 years old male. Between July 2000 and July 2001, I had four encounters with different sex workers (Russian, Swiss, Argentinean, Australian) in New York City. In my first encounter (Russian), I had unprotected (without condom) oral sex (my penis in her mouth). At that time I didnt know that oral sex carried any risk. In my second encounter (Swiss), I had protected oral (my penis in her mouth) and vaginal sex. In third and fourth encounters (Argentinean and Australian), I had oral sex (my penis in their mouth). In July 2001, I felt really disgusted and ashamed at myself for going to sex workers. I was raised with extremely strong moral values and here I had sunk so low. After that I decided to practice absolute abstinence and felt fine but a couple of illnesses in next few months destroyed my peace of mind.

Event 1 In January 2002, I had a sore throat, which lasted for a week. But this sore throat was accompanied with dry cough that lasted for a month. During this period, I got extremely paranoid that I had contracted HIV based on the research I did on Internet regarding the symptoms associated with HIV infection. I gathered some courage and decided to take the Home Access test. The test came back negative. My cough ended pretty much the same time as I got my results. I was extremely overjoyed and everything got back to normal and I got busy with my work.

Event 2 In August 2002, I again had dry cough for two weeks. As the cough went away in two weeks I didnt think much about it.

Event 3 In December 2002, I had a chicken pox that lasted for seven days. This was the first time in my life that I had chicken pox. I became extremely paranoid and started going on Internet to read about HIV. Due to what I read on Internet I became convinced that I had HIV infection and that my Home Access Test wasnt reliable. I couldnt handle the anxiety and I decided to go to my Internist. I told him the whole story. He suggested that I take HIV test once again. I took the HIV test again. My doctor called and said that test result were negative. The test result said, no HIV-1 antibodies found (the test was done by Quest Diagnostics). The doctor also informed me that I had no STDs. I felt extremely relieved and got back to my day-to-day business.

Between December 2002 and February 2003, I went to strip club with my friends four times. On all four of these occasions, due to my temptations I ended up getting a Hand Job from the strippers. From what I recall I dont think that they touched their private parts. In February 2003, feeling guilt that I could control my urges, I decided that I would never go to a strip club. I started to feel good again about myself till:

Event 4 On March 27, 2003, I had a sore throat, ringing sound in my ear, and cough. I took medication and my sore throat and ringing sound was cured in 5 days but my cough lasted for another 10 days. The cough got me stressed again. I started reading about HIV on Internet and again I became convinced that I had contracted HIV because of the Hand Jobs or my earlier sexual encounters. I got extremely distressed and decided to go back to my Internist and he said that I dont have HIV. He recommended that there was no need for me to take the test again as it would be negative. I asked him if I should take Hiv-2 test. His answer was that I dont need to take HIV-2 test as there was no risk for me contracting HIV-2. After meeting the Internist, I started feeling better and my cough was gone. But this didnt last long. On April 18, I again started getting the ringing sound in my ear. This was accompanied by cough. I went to see my internist again, who told me that it had nothing to do with HIV and told me to go see an ENT. I went to see an ENT, who based on the culture he took from ear concluded that I had Streptococcal Infection in my ear and that is what was causing the cough and the rigging sound in my ear. This is the first time I have had ear infection. I have been on antibiotic since April 23, 2003 and my cough has improved and the ringing sound in my ear has become lesser but I am not 100 cured. I am feeling some kind of sensation around my armpits. I dont know if the sensation really exists or I am just imagining it (my Internist told me that I dont have swollen lymph nodes around my arm pits). I am extremely distressed and ashamed. I have let everyone around me down. I have a few questions for you.

(1) Do you think my test results are 100 correct and conclusive that I dont have HIV? (2) Do you think that I might have HIV and is that why I have had these infections (chicken pox, ear infection, sore throat, dry cough)? (3) Do you think I need to get tested for HIV-1 again? (4) Do you think I need to get tested for HIV-2? (5) Do you think I am perfectly fine and can I WOO-HOO?

I know you are extremely busy. I am extremely sorry for posting such a long message. I need your opinion on this one. I request you please e-mail me promptly. I cant sleep during nights. I want to start feeling better and put these ghost behind me.

You are a great person. I admire you. I will definitely making a donation to the great cause you are involved in through your foundation and this forum. Thanks.

Response from Dr. Frascino

Hello Worried, Stressed, Distressed!

Wow Russian, Swiss, Argentinean, and Australian hookers? Youve got your own little United Nations going on there! OK, the answers to your questions are:

1. Yes, your HIV tests are absolutely conclusive. You are HIV-negative. 2. No, as I said in number 1, your HIV tests are conclusive. You are HIV-negative. 3. No, further HIV tests are not warranted. 4. No, as I said in number 3, further HIV tests are not warranted. 5. Yes, as I said in numbers 1-4, you are absolutely HIV-negative and do not need additional testing. That means WOO-HOO!

Now that thats out of the way, Ill briefly mention a few things:

1. Oral sex carries an extremely low risk for acquiring HIV. "Protected" oral sex carries no risk. "Protected" vaginal sex (latex condom) also carries no risk if the condom is used properly. 2. Researching HIV symptoms on the Internet is a waste of time, particularly since you had negative HIV and STD tests greater than 3 months after your potential exposure. 3. Hand jobs are not a risk for HIV transmission. 4. Absolute abstinence is a personal choice, but one that at least for me would be absolutely impossible. Why are you ashamed of sex? Its perfectly natural. Your "extremely strong moral values" are causing you unnecessary and completely unwarranted guilt. 5. You havent let anyone down.

Why not consider seeing a counselor who can help you cope with some of your guilt feelings? A healthier attitude toward sexuality could relieve many of your problems! Hope you are no longer worried, stressed, or distressed!

Stay well.

Dr. Bob

Working with HIV and Aids Children

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